Srp Arh Celok Lek [JOURNAL]
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200 papers
Postponed diagnosis of alpha-1 antitrypsin deficiency.
Stojković-Lalošević M, Stjepanović M, Čolović N … +3 more , Marić-Živković J, Mihailović-Vučinić V, Stojković M
Srp Arh Celok Lek · 2016 · PMID 29659238
Abstract loading — click title to view on PubMed.
Development of cardiopulmonary bypass – A historical review.
Šušak S, Redžek A, Rosić M … +2 more , Velicki L, Okiljević B
Srp Arh Celok Lek · 2016 · PMID 29659237
The idea of isolated organ perfusion, a precursor of cardiopulmonary bypass, came by Legalois in 1812. First isolated organ perfusion was described by Loebell in 1849. The first closed system for oxygenation and returnin...
The idea of isolated organ perfusion, a precursor of cardiopulmonary bypass, came by Legalois in 1812. First isolated organ perfusion was described by Loebell in 1849. The first closed system for oxygenation and returning the blood through arteries was created by Frey and Gruber in 1885. Gibbon Jr. is considered the father of extracorporeal circulation. In spring of 1934 he began constructing a machine for extracorporeal circulation in Boston. He published the first description of this system in 1937. Gibbon won the grant of the International Business Machines Corporation for developing the machine in 1947. Together they developed Model I in 1949 and Model II in 1951. After a few unsuccessful attempts in 1952, the first successful surgical intervention on the heart (closure of atrial septal defect) using cardiopulmonary bypass was performed on May 6, 1953. In 1945, Kirklin and his working group reported on a series of eight successfully treated patients in a row who underwent surgery with extracorporeal circulation. First successful valve surgery under the direct vision was performed by Dodrill in 1952, using his “Michigan Heart” machine as a right heart bypass. Using cardiopulmonary bypass, cardiac surgeons can deal with the complex cardiac pathology and save millions of lives.
Shiga toxin-producing Escherichia coli hemolytic uremic syndrome.
Peco-Antić A
Srp Arh Celok Lek · 2016 · PMID 29659236 · Publisher ↗
The hemolytic–uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury (AKI). The major cause of HUS in childhood (>90%) is infection with verocytotoxin (Shig...
The hemolytic–uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury (AKI). The major cause of HUS in childhood (>90%) is infection with verocytotoxin (Shiga-like toxin – “Stx”)-producing bacteria, usually enterohemorrhagic Escherichia coli (VTEC/STEC). The infection may be transmitted by the consumption of undercooked meat, pasteurized dairy products, contaminated vegetables, fruits and water, or by contact with STEC diarrhea. After an incubation period of three to eight days, patients commonly develop bloody diarrhea followed in 5–22% by HUS that may be complicated by central nervous system, pancreatic, skeletal, and myocardial involvement. HUS is one of the main causes of AKI in children in Europe. The management of HUS includes the usual treatment of children with AKI. Transfusion with packed red blood cells is needed in case of a severe anemia, while platelet transfusions are limited to the need for a surgical procedure or in active bleeding. Currently, there is no consensus on the use of antibiotic therapy. Treatment with plasma and/or plasma exchange has not been proven beneficial in STEC-HUS. Eculizumab has been used for the treatment of STEC-HUS, but the value of this treatment remains to be determined. The mortality of HUS is reported to be 3–5%. About 12% of patients will progress to end-stage renal failure within four years and about 25% will have long-term complications, including hypertension, proteinuria, renal insufficiency, and insulin-dependent diabetes mellitus. Transplantation can be performed without increased risk for the recurrence of the disease.
Hepatocellular carcinoma and impact of aflatoxin difuranocoumarin derivative system – A case report.
Ilić M, Putnik SS, Prvulović-Bunović N … +4 more , Vojinović-Miloradov M, Mihajlović I, Turk-Sekulić M, Radonić J
Srp Arh Celok Lek · 2016 · PMID 29659235
INTRODUCTION: Hepatocellular carcinoma (HCC) is the most frequent type of liver malignancy. As a carcinogen, aflatoxin B1 (AFB1) causes HCC by inducing deoxyribonucleic acid adducts that lead to genetic changes in liver...
INTRODUCTION: Hepatocellular carcinoma (HCC) is the most frequent type of liver malignancy. As a carcinogen, aflatoxin B1 (AFB1) causes HCC by inducing deoxyribonucleic acid adducts that lead to genetic changes in liver cells and may be the cause of HCC in up to 30% of cases. The incidence of HCC has been on the rise and is an issue in the countries of the Western Balkans. CASE OUTLINE: This paper presents a case of a 37-year-old woman who was diagnosed with HCC, without hepatitis B, hepatitis C, or liver cirrhosis. The patient consumed milk and dairy products in quantities of over two liters per day over the course of 20 years, which indicates the impact of aflatoxin in milk on HCC. A positive signal for the presence of AFB1 was detected by ELISA (enzyme-linked immunosorbent assay) in-house using immunoperoxidase screening test. CONCLUSION: As carcinogenic difuranocoumarin derivative, aflatoxin B1 is the most likely cause of malignant transformation of hepatocytes, which resulted in hepatocellular carcinoma in this patient.
Mucormycosis of the paranasal sinuses in a patient with acute myeloid leukemia.
Čolović N, Arsić-Arsenijević V, Barać A … +3 more , Suvajdžić N, Leković D, Tomin D
Srp Arh Celok Lek · 2016 · PMID 29659234
INTRODUCTION: Invasive fungal infection is among the leading causes of morbidity, mortality, and economic burden for patients with acute leukemia after induction of chemotherapy. In the past few decades, the incidence of...
INTRODUCTION: Invasive fungal infection is among the leading causes of morbidity, mortality, and economic burden for patients with acute leukemia after induction of chemotherapy. In the past few decades, the incidence of invasive fungal infection has increased dramatically. Its management has been further complicated by the increasing frequency of infection by non-Aspergillus molds (e.g. Mucorales). Neutropenic patients are at a high risk of developing an invasive mucormycosis with fulminant course and high mortality rate (35–100%). CASE OUTLINE: We are presenting the case of a 72-year-old male with an acute monoblastic leukemia. The patient was treated during five days with hydroxycarbamide 2 × 500 mg/day, followed by cytarabine 2 × 20 mg/sc over the next 10 days. He developed febrile neutropenia, headache, and edema of the right orbital region of the face. Computed tomography of the sinuses revealed shadow in sinuses with thickening of mucosa of the right paranasal sinuses. Lavage and aspirate from the sinuses revealed Rhizopus oryzae. Mucormycosis was successfully treated with amphotericin B (5 mg/kg/day) followed by ketoconazole (400 mg/day). Two months later the patient died from primary disease. CONCLUSION: In patients with acute leukemia who developed aplasia, febrile neutropenia, and pain in paranasal sinuses, fungal infection should be taken into consideration. New and non-invasive methods for taking samples from sinuses should be standardized in order to establish an early and accurate diagnosis of mucormycosis with the source in paranasal sinuses, and to start early treatment by a proper antifungal drug. Clear communication between physician and mycologist is critical to ensure proper and timely sampling of lavage and aspirate from sinuses and correct specimen processing when mucormycosis is suspected clinically.
Fondaparinux monitoring in a patient with heparin-induced thrombocytopenia on hemodialysis.
Kušić J, Kulić A, Djurković V … +4 more , Marković R, Milačić V, Surić-Lambić L, Peković G
Srp Arh Celok Lek · 2016 · PMID 29659233
INTRODUCTION: Heparin-induced thrombocytopenia associated to hemodialysis is rare. In case when citrate dialysis and/or non-heparin anticoagulants are not available, only possible medication to use for anticoagulation du...
INTRODUCTION: Heparin-induced thrombocytopenia associated to hemodialysis is rare. In case when citrate dialysis and/or non-heparin anticoagulants are not available, only possible medication to use for anticoagulation during hemodialysis is fondaparinux. However, laboratory monitoring of fondaparinux based on anti-Xa activity in dialysis patients has not been sufficiently documented yet. CASE OUTLINE: We created a local anti-factor Xa assay for measuring fondaparinux plasma concentration and efficacy in a patient with heparin-induced thrombocytopenia during hemodialysis. Fondaparinux given subcutaneously increases risk of adverse events due to its extended release and prolonged maintenance of toxic levels. When used intravenously fondaparinux remains safe, with reached steady-state level within dialysis and low risk of toxicity afterwards. CONCLUSION: Fondaparinux may be used as an alternative anticoagulant medication during hemodialysis in patients who develop heparin-induced thrombocytopenia. Adequate dose must be adjusted to patients’ dry weight (0.03 mg/kg intravenously) and fondaparinux anti-coagulation monitoring must be provided.
Atypical, polyarticular lipoma arborescens in a child.
Semnic R, Simić R, Djuričić S … +2 more , Adjić O, Vanhoenacker F
Srp Arh Celok Lek · 2016 · PMID 29659232
INTRODUCTION: Lipoma arborescens is a rare, tumor-like lesion commonly involving synovial joints and less commonly bursae and synovial tendon sheaths. CASE OUTLINE: We report a case of a 12-year-old boy with symmetric in...
INTRODUCTION: Lipoma arborescens is a rare, tumor-like lesion commonly involving synovial joints and less commonly bursae and synovial tendon sheaths. CASE OUTLINE: We report a case of a 12-year-old boy with symmetric involvement of the bicipitoradial bursae, synovial sheaths of extensor compartments of both hands and medial ankles. The diagnosis of polyarticular lipoma arborescens was proposed on magnetic resonance (MR) imaging and this diagnosis was histologically proven after biopsy of the bursae and later by open surgery of the synovial sheath of the right ankle tendons. Literature search was performed and twelve cases with polyarticular involvement were analyzed. Lipoma arborescens commonly involves suprapatellar recess of the knee and very rarely other joints or bursae. Histological analysis revealed an accompanying non-necrotizing granulomatous synovial inflammation. CONCLUSION: Polyarticular lipoma arborescens is a rare entity and symmetrical involvement of the joints other than the knees is exceedingly rare. MR imaging plays a significant role in the diagnostic protocol, and the characteristic fatty signal on MR imaging is highly suggestive of lipoma arborescens.
Synchronous advanced pulmonary tuberculosis and acute virus myocarditis mimicked Wegener granulomatosis in a 26-year-old man – A case report.
Pešut DP, Petrović MŽ, Vasić NR … +1 more , Stević RS
Srp Arh Celok Lek · 2016 · PMID 29659231
INTRODUCTION: Tuberculosis patients are rarely asymptomatic. Acute virus myocarditis presents with a wide range of symptoms, from mild dyspnea or chest pain to cardiogenic shock and death. CASE OUTLINE: A 26-year-old Cau...
INTRODUCTION: Tuberculosis patients are rarely asymptomatic. Acute virus myocarditis presents with a wide range of symptoms, from mild dyspnea or chest pain to cardiogenic shock and death. CASE OUTLINE: A 26-year-old Caucasian man non-smoker presented with one-week history of lower extremities’ swelling. The patient’s medical history also revealed a two-day episode of subfebrile temperature with scanty hemoptysis three weeks prior to admission. The episode had not provoked him to seek medical care. Physical examination revealed generalized oedema, and laboratory analysis showed signs of acute renal insufficiency. Enlarged heart and hilar shadows, bilateral massive cavitary pulmonary opacities and pleural effusion were found at chest radiography. Sputum smears were Mycobacteria negative on direct microscopy. Electrocardiogram changes and echocardiography were suggestive of acute myocarditis with dilated cardiomyopathy. IgM titer to adenovirus was positive. Under diuretics, angiotensin-converting-enzyme inhibitor, beta-blocker, antibiotics and bed rest, fast heart compensation and renal function repair were achieved. Radiographic pulmonary changes promptly regressed except for a cavity in the right upper lobe. Bronchial aspirate from the affected lobe was Mycobacteria positive on direct microscopy and culture positive for Mycobacterium tuberculosis. Standard anti-tuberculosis drug regimen led to recovery. CONCLUSION: In the unusual common existence of two diseases whose presentation initially mimicked Wegener’s granulomatosis, acute dilated cardiomyopathy contributed to pulmonary tuberculosis detection. To prevent diagnostic delay in tuberculosis, further efforts in population education are necessary together with continual medical education
The onset of systemic lupus erythematosus and thyroid dysfunction following Graves’ disease – A case report and literature review.
Zhanga Y, Xiaoa X, Haoa Q … +3 more , Lia X, Renb J, Hu Z
Srp Arh Celok Lek · 2016 · PMID 29659229 · Publisher ↗
INTRODUCTION: Graves’ disease is a multifactorial autoimmune thyroid disease, with the presence of typical circulating autoantibodies that can activate the thyroid hormone receptors, resulting in hyperthyroidism, goiter,...
INTRODUCTION: Graves’ disease is a multifactorial autoimmune thyroid disease, with the presence of typical circulating autoantibodies that can activate the thyroid hormone receptors, resulting in hyperthyroidism, goiter, and ophthalmopathy. Systemic lupus erythematosus is a multi-systemic autoimmune disease that involves almost all the organs of the human body and is characterized by autoantibodies formation. Several studies have reported that autoimmune thyroid and rheumatic disorders can present an unusual relationship. CASE OUTLINE: We report a case of a middle-aged woman who presented with systemic lupus erythematosus one year after being diagnosed with Graves’ disease. Prednisone and cyclophosphamide were administered to control the development of systemic lupus erythematosus. Furthermore, a percutaneous thyroid biopsy was performed for further confirmation of Graves’ disease. Methimazole instead of propylthiouracil was added into the therapeutic scheme. A month later, the patient’s clinical manifestation and laboratory tests got significant improvement, except that new thyr o id dysfunction appeared opposite to the original one. The administration of anti-thyroid drug was discontinued. With a period of decreased administration of prednisone, the patient’s thyroid function gradually got back to normal levels without any levothyroxine replacement. CONCLUSION: In conclusion, the clinical use of prednisone and antithyroid drugs may result in instability of the hypothalamus–pituitary–thyroid axis, and thyroid function should be carefully monitored in such patients.
Quality of osteoarthritis care in family medicine – A cross-sectional study.
Račić M, Tošić M, Mašić S
Srp Arh Celok Lek · 2016 · PMID 29659228
INTRODUCTION: Effective treatments for osteoarthritis are available, yet little is known about the quality of primary care in the Republic of Srpska for this disabling condition. OBJECTIVE: The main objective of this stu...
INTRODUCTION: Effective treatments for osteoarthritis are available, yet little is known about the quality of primary care in the Republic of Srpska for this disabling condition. OBJECTIVE: The main objective of this study was to analyze the overall quality of osteoarthritis treatment in a family medicine setting, as well as to explore whether the achievement of quality indicators was associated with particular patient characteristics and severity of osteoarthritis. METHODS: The cross-sectional study included 120 patients with confirmed hand, knee, and hip osteoarthritis, recruited at seven family practices in the town of Ugljevik, Republic of Srpska, Bosnia and Herzegovina. Data were extracted from a patient questionnaire on quality indicators, as well as from their electronic and paper records, to assess care against 14 indicators. The included quality indicators were based on the Arthritis Foundation’s Quality Indicator set for Osteoarthritis. Summary achievement rates for hip, knee, or hand osteoarthritis, as well as for the total sample, were calculated. RESULTS: The mean achievement rate for all 14 quality indicators obtained from medical records was 74%, and 77% obtained from patient interview. The quality indicators concerning referral for weight reduction (23%) and pharmacological treatment (24%) had the lowest achievement rates, whereas the highest achievement rates were related to physical examination (100%), pain and functional assessment (100%), and education (90.8%). Patients physical functioning was significantly associated with the quality indicator achievement rate (p = 0.001). CONCLUSION: Pharmacological therapy and the referral of osteoarthritis patients in need of weight reduction seem to have the greatest potential for improvement in primary health care.
Risk factors for severe influenza A virus infections in post-2009 pandemic period.
Radovanov J, Hrnjaković-Cvjetković I, Nikolić N … +5 more , Jovanović-Galović A, Kovačević G, Patić A, Milošević U, Milošević V
Srp Arh Celok Lek · 2016 · PMID 29659225
INTRODUCTION: Literature data concerning risk factors for severe influenza in post-2009 pandemic period, from low- and middle-income Central and Eastern European countries are very limited. OBJECTIVE: The aim of this stu...
INTRODUCTION: Literature data concerning risk factors for severe influenza in post-2009 pandemic period, from low- and middle-income Central and Eastern European countries are very limited. OBJECTIVE: The aim of this study was to investigate the risk factors for severe A(H1N1)pdm09 and A(H3N2) influenza during the post-2009 pandemic period. METHODS: During four consecutive seasons of 2010/2011–2013/2014, nasopharyngeal or nasal and pharyngeal swab samples from 153 patients with mild and 147 patients with severe influenza were tested using real-time reverse transcription polymerase chain reaction (real-time RT PCR) assays. RESULTS: The study indicated three statistically significant risk factors of influenza severity, including presence of chronic underlying illness/condition [odds ratio (OR) of 15.2, 95% confidence interval (CI) of 1.8–125.4, p = 0.001), age ≥15 years (OR 9.2, 95% CI 3.5–24.1, p < 0.001), and delay in medical care of more than two days after the symptoms onset (OR 3.2, 95% CI 1.6–6.4, p = 0.001). CONCLUSION: Obtained results confirmed that patients with chronic underlying illness/condition and older than 15 years had the highest risk for serious complications from influenza and highlighted the importance of start of antiviral therapy within the first two days of illness in order to reduce the risk for the most severe outcomes of influenza, such as acute respiratory distress syndrome and lethal outcome.
Negative-pressure wound therapy for deep groin vascular infections.
Matić P, Tanaskovic S, Živić R … +7 more , Jocić D, Gajin P, Babić S, Soldatović I, Vučurević G, Nenezić D, Radak D
Srp Arh Celok Lek · 2016 · PMID 29659224
INTRODUCTION: Infection of synthetic graft in the groin is a rare but devastating complication. When it occurs, several possibilities of treatment are available. Extra-anatomic reconstruction and in-situ implantation of...
INTRODUCTION: Infection of synthetic graft in the groin is a rare but devastating complication. When it occurs, several possibilities of treatment are available. Extra-anatomic reconstruction and in-situ implantation of new, infection resistant grafts are associated with high mortality and morbidity. Therefore, more conservative approach is needed in some cases. Negative-pressure wound therapy is one of the options in treating such patients. OBJECTIVE: The aim of this study was to assess the outcome for deep groin vascular graft infection treated with negative-pressure wound therapy. METHODS: Seventeen patients (19 wounds), treated for Szilagyi grade III groin infections between October 2011 and June 2014, were enrolled into this observational study. RESULTS: Majority of the wounds (11/19) were healed by secondary intention, and the rest of the wounds (8/19) were healed by primary intention after initial negative-pressure wound therapy and graft substitution with silver-coated prostheses or autologous artery/vein implantation. No early mortality was observed. Minor bleeding was observed in one patient. Reinfection was noted in three wounds. Only one graft occlusion was noted. Late mortality was observed in three patients. CONCLUSION: Negative-pressure wound therapy seems to be safe for groin vascular graft infections and comfortable for both patient and surgeon. However, the rate of persistent infection is high. This technique, in our opinion, can be used as a “bridge” from initial wound debridement to definitive wound management, when good local conditions are achieved for graft substitution, either with new synthetic graft with antimicrobial properties or autologous artery/vein. In selected cases of deep groin infections it can be used as the only therapeutic approach in wound treatment.
Biochemical liver function test parameter levels in relation to treatment response in liver metastatic colorectal patients treated with FOLFOX4 with or without bevacizumab.
Denić K, Tarabar D, Obradovic S … +4 more , Ristić M, Spasić J, Radosavljević D, Ugrešić N
Srp Arh Celok Lek · 2016 · PMID 29659222
INTRODUCTION: Combined use of bevacizumab and conventional anticancer drugs leads to a significant improvement of treatment response in patients with metastatic colorectal carcinoma (CRC). Conventional treatment protocol...
INTRODUCTION: Combined use of bevacizumab and conventional anticancer drugs leads to a significant improvement of treatment response in patients with metastatic colorectal carcinoma (CRC). Conventional treatment protocols exert undesired effects on the liver tissue. Hepatotoxic effects are manifested as a disturbance of liver function test parameters. The relation between clinical outcome and disorder of biochemical parameters has not been completely evaluated. OBJECTIVE: The objective of our study was to examine whether clinical outcome in patients with liver metastatic CRC correlates with the level of liver function test parameters. METHODS: The study included 96 patients with untreated liver metastatic CRC who received FOLFOX4 protocol with or without bevacizumab. Biochemical liver parameters were performed before and after the treatment completion. Treatment response was evaluated as disease regression, stable disease, and disease progression. The patients were divided into three groups according to the accomplished treatment response. RESULTS: In the group of patients with disease regression the post-treatment levels of aspartate aminotransferase, alanine aminotransferase, and bilirubin were statistically significantly increased. In contrast to this, gamma-glutamyltransferase and protein post-treatment values were significantly lower in relation to initial values. In patients with stable disease, difference was found only in the level of proteins being lower after the treatment. In patients with disease progression, values of aspartate aminotransferase and bilirubin were significantly increased after completed treatment. CONCLUSION: Treatment responses are not completely associated with the level of liver function test parameters. The only parameter which correlated with treatment response is gamma-glutamyltransferase. Its decrease is accompanied with disease regression.
Prevalence and risk factors of vascular calcification in pre-dialysis patients with Balkan endemic nephropathy.
Petković N, Marić R, Gajanin R … +4 more , Batinić D, Ćuk M, Ristić S, Djukanović L
Srp Arh Celok Lek · 2016 · PMID 29659221
INTRODUCTION: Vascular calcifications (VC) are common in patients with chronic kidney disease and present one of manifestations of mineral and bone disorders in these patients. OBJECTIVE: The aim of this pilot study was...
INTRODUCTION: Vascular calcifications (VC) are common in patients with chronic kidney disease and present one of manifestations of mineral and bone disorders in these patients. OBJECTIVE: The aim of this pilot study was to examine the prevalence and risk factors of VC in pre-dialysis patients with Balkan endemic nephropathy (BEN) and other kidney diseases. METHODS: The study involved 32 pre-dialysis patients, 15 with BEN and 17 with other kidney diseases. All the patients underwent an interview, objective examination, routine laboratory analyses and measurement of serum concentration of intact parathyroid hormone (iPTH), 25-hydroxyvitamin D3 [25(OH)D3] and osteopontin. VCs in iliac, femoral, radial, and digital arteries were evaluated and Adragao VC score was calculated. The samples of radial artery were collected during the first creation of an arteriovenous fistula, and expression of osteocalcin, bone morphogenic protein-2 osteopontin, and matrix Gla-protein in arterial wall were examined. RESULTS: Patients with BEN were significantly older (71.1 ± 6.1 vs. 54.7 ± 11.1 years), but they had significantly lower systolic and mean blood pressure (95.7 ± 13.2 mmHg vs. 104.3 ± 7.4 mmHg) and lower serum concentration of phosphorus (1.32 ± 0.36 mmol/l vs. 1.65 ± 0.35 mmol/l) and cholesterol (4.3 ± 1.1 mmol/l vs. 5.2 ± 0.8 mmol/l) than patients with other kidney diseases. Mean VC score was significantly lower in patients with BEN than in those with other kidney diseases (2.8 ± 1.7 vs. 4.6 ± 1.8; p = 0.009), but expression of four examined proteins in arterial wall differed insignificantly between the two groups. VC score correlated significantly with serum concentrations of cholesterol, triglycerides (positively), and iPTH (negatively). CONCLUSION: Pre-dialysis BEN patients had a significantly lower mean score of VC than patients with other kidney diseases.
The role of the color Doppler ultrasonography and computed tomography in estimation of portal hypertension.
Nićiforović D, Till V, Vučaj-Ćirilović V … +6 more , Petrović K, Juković M, Hadnađev-Šimonji D, Savić Ž, Stokić E, Šarčev K
Srp Arh Celok Lek · 2016 · PMID 29659219
INTRODUCTION: Liver diseases with disturbances of hepatic and splanchnic circulation lead to the portal hypertension, with or without a portal vein thrombosis. OBJECTIVE: This study was based on the testing of hypothesis...
INTRODUCTION: Liver diseases with disturbances of hepatic and splanchnic circulation lead to the portal hypertension, with or without a portal vein thrombosis. OBJECTIVE: This study was based on the testing of hypothesis that more data and more precise diagnosis in patients with disorders of portal circulation can be obtained by using color Doppler ultrasonography (CDU) and computed tomography (CT) with contrast. METHODS: The study was conducted from February 2011 to May 2014 and it comprised 120 patients who were suspected to have portal hypertension or already had clinical confirmation of the portal hypertension, patients with hepatitis, and some patients with hematological diseases. The first group of 40 patients was examined by conventional ultrasonography and CDU, the second group by contrast CT, and the third group of patients was examined by both methods (CDU and contrast CT). After six months of adequate therapy, the patients had control examinations with the same diagnostic technique used during their first examination. RESULTS: Retrospective analysis showed that CDU is more sensitive than CT in the assessment of presence and age of thrombi (CDU 93.9%; CT 86.1%). CT gives precise data in detection of portosystemic collaterals. Sensitivity of CT is 100% and its specificity is 67%. Cumulative sensitivity and specificity for most parameters were increased in patients with portal hypertension when both methods were applied. CONCLUSION: This study emphasizes the possibility of early and more accurate diagnosis achieved when combining two radiological techniques (CDU and contrast CT scan), which is not the case when these methods are used separately.
Is pacemaker therapy the right key to patients with vasovagal syncope?
Radovanović NN, Kirćanski B, Raspopović S … +3 more , Pavlović SU, Jovanović V, Milašinović G
Srp Arh Celok Lek · 2016 · PMID 29659218
INTRODUCTION: Vasovagal syncope is the most common type of reflex syncope. Efficacy of cardiac pacing in this indication has not been the subject of many studies and pacemaker therapy in patients with vasovagal syncope i...
INTRODUCTION: Vasovagal syncope is the most common type of reflex syncope. Efficacy of cardiac pacing in this indication has not been the subject of many studies and pacemaker therapy in patients with vasovagal syncope is still controversial. OBJECTIVE: This study aimed to assess the efficacy and safety of pacing therapy in treatment of patients with vasovagal syncope, to determine contribution of new therapeutic models in increasing its success, and to identify risk factors associated with a higher rate of symptoms after pacemaker implantation. METHODS: A retrospective study included 30 patients with pacemaker implanted due to vasovagal syncope in the Pacemaker Center, Clinical Center of Serbia, between November 2003 and June 2014. Head-up tilt test was performed to diagnose vasovagal syncope. Patients with cardioinhibitory and mixed type of disease were enrolled in the study. RESULTS: Mean age was 48.1 ± 11.1 years and 18 (60%) patients were men. Mean follow-up period was 5.9 ± 3.0 years. Primarily, implantable loop recorder was implanted in 10 (33.3%) patients. Twenty (66.7%) patients presented cardioinhibitory and 10 (33.3%) mixed type of vasovagal syncope. After pacemaker implantation, 11 (36.7%) patients had syncope. In multiple logistic regression analysis we showed that syncope is statistically more likely to occur after pacemaker implantation in patients with mixed type of vasovagal syncope (p = 0.018). There were two (6.7%) perioperative surgical complications. CONCLUSION: Pacemaker therapy is a safe treatment for patients with vasovagal syncope, whose efficacy can be improved by strict selection of patients. We showed that symptoms occur statistically more often in patients with mixed type of disease after pacemaker implantation.
The effects of implementation of guideline-directed medical therapy on relief of angina in patients with stable coronary artery disease in Serbia.
Ilić I, Stanković I, Janićijević A … +14 more , Kušić J, Vidaković R, Otašević P, Andrić V, Poznanović S, Petrović I, Burazor I, Ristić A, Ilić S, Benc D, Davidović G, Stojković G, Putniković B, Nešković AN
Srp Arh Celok Lek · 2016 · PMID 29659217
Abstract loading — click title to view on PubMed.
Self-perception and satisfaction with dental appearance and aesthetics with respect to patients’ age, gender, and level of education.
Strajnić L, Bulatović D, Stančić I … +1 more , Živković R
Srp Arh Celok Lek · 2016 · PMID 29659216
INTRODUCTION: Patient’s subjective evaluation of dental appearance and aesthetics is becoming an increasingly important factor in aesthetic treatments and prosthetic therapy. OBJECTIVE: The aim of this study was to inves...
INTRODUCTION: Patient’s subjective evaluation of dental appearance and aesthetics is becoming an increasingly important factor in aesthetic treatments and prosthetic therapy. OBJECTIVE: The aim of this study was to investigate the influence of age, education level, gender, and different dental status and the appearance of the upper anterior teeth (color, size, shape, position and alignment of the anterior teeth) on the satisfaction of the respondents with dental appearance and aesthetics of their upper anterior teeth and their desire for improvement. METHODS: The study encompassed 480 people aged 20 to 50 years with an average age of 30.84 years. There were 236 male and 244 female subjects. The respondents were interviewed using a questionnaire specially designed for the purpose of this research. For the study, the subjects were divided into the following three age groups: the younger age group (20–30 years of age), the middle age group (31–40 years of age), and the older age group (41–50 years of age). RESULTS: The conducted study did not reveal statistical significance with respect to gender in any of the examined parameters (p > 0.05). A little more than one half of the respondents in each age group were satisfied with their dental appearance and aesthetics (60.3% of the respondents in the age group of 20–30 years, 55.7% in the age group of 31–40, and 53.7% in the age group of 41–50 years of age). Satisfaction with dental appearance and aesthetics increases linearly with the increase in the level of education and was the highest among the respondents with university degree (33.3%). CONCLUSION: Female respondents were more dissatisfied with their dental appearance and aesthetics as compared with male respondents, but the difference was found to be non-significant. Patients with higher education level were more satisfied with their dental appearance and aesthetics than those with lower education.
The effect of recasting on biological properties of Ni-Cr dental alloy.
Čairović A, Maksimović V, Radović K … +1 more , Djurišić S
Srp Arh Celok Lek · 2016 · PMID 29659215
INTRODUCTION: Increases in market prices of gold over the last 20 years have led to expansion of basic dental alloys, which, primarily due to their good mechanical properties and acceptable prices, have found their place...
INTRODUCTION: Increases in market prices of gold over the last 20 years have led to expansion of basic dental alloys, which, primarily due to their good mechanical properties and acceptable prices, have found their place in everyday dental practice. However, within the procedure of making dental prosthetic restorations, the alloys are melted and cast, which leads to changes in their physical, mechanical and biological properties. OBJECTIVE: The objective of the study was to test biocompatibility of a Ni-Cr dental alloy (WIRON 99) depending on the number of melting and casting processes. METHODS: The working method included the testing of cytotoxicity of the alloy obtained by casting after one, after four, and after eight successive processes of melting. Cytotoxicity of samples was tested by means of a 24-hour and a three-day cytotoxicity test, done on L929 fibroblasts. RESULTS: A repeatedly melted and cast alloy shows a reduced biocompatibility and causes specific responses of the tissues in the surrounding area. Since the cytotoxic effect is more significant in the extended contact with the culture cells, a three-day cytotoxicity test showed discrete changes which were the indicator of cell growth inhibition in the cell culture. CONCLUSION: The obtained results confirm the working hypothesis that repeated alloy melting and casting will decrease biocompatibility of dental alloys and will lead to specific responses of the tissue in the surrounding area.
A rare localization of osteoid osteoma – Presentation of two cases.
Şeker A, Unal MB, Malkoç M … +3 more , Kara A, Sarikaya IA, Bulbul AM
Srp Arh Celok Lek · 2016 · PMID 29653045 · Publisher ↗
INTRODUCTION: Osteoid osteoma is a benign osteoid-forming tumor generally localized to the long bones, is rarely localized in the hand and the major symptom is intermittent pain. This study aims to present two patients w...
INTRODUCTION: Osteoid osteoma is a benign osteoid-forming tumor generally localized to the long bones, is rarely localized in the hand and the major symptom is intermittent pain. This study aims to present two patients who were operated on for metacarpal osteoid osteomas. CASE OUTLINE: A 16-year-old female patient and an 18-year-old male patient were operated on for metacarpal osteoid osteomas. The major symptom was intermittent pain for both patients. After surgical excision of the niduses, the complaints resolved in both cases. CONCLUSION: In the case of high suspicion for osteoid osteoma, computed tomography or magnetic resonance imaging should be performed due to the risk of negative radiographic findings. Surgical excision is curative and a safe method of treatment.
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